International journal of pediatric otorhinolaryngology最新文献

{"title":"Spontaneous tonsillar hemorrhage in a patient with PTEN mutation: A case report and systematic literature review","authors":"Molly O. Meeker ,&nbsp;Logan F. McColl ,&nbsp;Prashant S. Malhotra","doi":"10.1016/j.ijporl.2025.112315","DOIUrl":"10.1016/j.ijporl.2025.112315","url":null,"abstract":"<div><h3>Introduction</h3><div>Phosphatase and tensin homolog hamartoma tumor syndrome (PTEN Syndrome), an autosomal dominant group of disorders caused by PTEN dysregulation, predisposes patients to hamartomas, lipomas, vascular tumors/malformations, and potential malignancies. A link between PTEN syndrome and early onset enlargement of tonsillar tissue has been described. Presented is the case of a child with PTEN syndrome who experienced spontaneous tonsillar hemorrhage (STH), followed by a systematic review of the literature.</div></div><div><h3>Case description</h3><div>A 9-year-old female with PTEN syndrome presented with sore throat, globus sensation, and oral bleeding. After a positive rapid-streptococcus swab, and exam demonstrating an exophytic, highly irregular left tonsil with hemorrhagic changes, a diagnosis of STH was made. Computed-tomography-angiography (CTA) of the neck showed no major vascular malformations, with extravasation from a small vessel of the left tonsil, and she subsequently underwent bilateral total tonsillectomy. A systematic review was performed and yielded 41 total cases of STH, none involving PTEN syndrome.</div></div><div><h3>Discussion</h3><div>STH is a rare phenomenon commonly associated with acute or chronic tonsilitis. The presented patient had group A streptococcus pharyngitis but also evidence of arterial bleeding on CTA, suggesting contribution of PTEN syndrome. Within the systematic review, tonsillar pathologies in PTEN syndrome such as early tonsil enlargement were identified, but this is the first case of STH reported. Further, PTEN syndrome may lead to vascular anomalies, but their role in the presented case remains unknown. Further investigation is required to determine whether vascular anomalies and early tonsil enlargement associated with PTEN syndrome increase the risk of STH.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"192 ","pages":"Article 112315"},"PeriodicalIF":1.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy of intranasal mometasone furoate monotherapy or combination therapy with montelukast in pediatric adenoid hypertrophy: A systematic review and meta-analysis of randomized clinical trials","authors":"Rahaf H. Almutairi ,&nbsp;Meshal Bassam Albesher ,&nbsp;Razan Ayed Alboqami ,&nbsp;Abdullah Zaki Al-Fahd ,&nbsp;Rayan Fahad Z Alshehri ,&nbsp;Orjwan Hashem Ateeq ,&nbsp;Mohammed Halawani ,&nbsp;Jaber Alshammari","doi":"10.1016/j.ijporl.2025.112310","DOIUrl":"10.1016/j.ijporl.2025.112310","url":null,"abstract":"<div><h3>Purpose</h3><div>Adenoid hypertrophy (AH) is a prevalent pediatric condition associated with nasal obstruction, sleep-disordered breathing, and related comorbidities. This study evaluated comparative efficacies of Mometasone Furoate (MF) monotherapy and MF-Montelukast combination therapy in pediatric AH.</div></div><div><h3>Methods</h3><div>PubMed, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, Web of Science, Google Scholar, and Ovid MEDLINE were searched from their inception to August 22, 2024, and five randomized clinical trials (RCTs) with pediatric patients (age &lt;15 years, n = 416) with clinically diagnosed AH, managed with MF monotherapy or MF–montelukast combination therapy, were identified. Outcomes included changes in x-ray adenoids/nasopharynx ratio, endoscopic adenoid obstruction, total symptom score, and individualized symptoms scores of nasal obstruction, rhinorrhea, mouth breathing, and snoring. <strong>Although safety data, including neuropsychiatric adverse effects of montelukast, were of interest, they were not reported in the included studies.</strong></div></div><div><h3>Results</h3><div>Compared to MF-monotherapy, MF–montelukast combination therapy significantly improved (mean difference [95 % confidence interval], <em>p</em>-value) adenoids/nasopharynx ratio (−7.01 [−8.96 to −5.07], &lt;0.001), total symptom score (−1.05 [−1.51 to −0.59], &lt;0.001), rhinorrhea (−0.92 [−1.50 to −0.34], 0.002), mouth breathing (−0.67 [−1.27 to −0.08], 0.02), and endoscopic Grade 4 adenoid obstruction (relative risk 0.25 [0.07–0.84], 0.03); no intergroup differences were noted in nasal obstruction (−0.06 [−0.26 to 0.14], 0.56), snoring (−0.56 [−1.19 to 0.08], 0.08), and endoscopic Grade 3 adenoid obstruction (relative risk 0.70 [0.45–1.09], 0.11).</div></div><div><h3>Conclusion</h3><div>MF–montelukast combination therapy is superior to MF monotherapy in reducing AH symptoms. However, Montelukast has an FDA black box warning due to potential neuropsychiatric side effects, including suicidal thoughts, depression and behavioral changes. None of the included studies systematically assessed these adverse effects highlighting a critical gap in safety evaluation. High-quality RCT-based research is required to evaluate long-term efficacy, safety, dosage, and cost-effectiveness.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"192 ","pages":"Article 112310"},"PeriodicalIF":1.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of oral tie diagnosis and treatment in Southwestern Ontario: A survey study","authors":"Ayushi Bhatt ,&nbsp;Brooke Turner ,&nbsp;Jacob Davidson ,&nbsp;Claire A. Wilson ,&nbsp;Peng You ,&nbsp;Murad Husein ,&nbsp;Josee Paradis ,&nbsp;Julie E. Strychowsky ,&nbsp;M. Elise Graham","doi":"10.1016/j.ijporl.2025.112306","DOIUrl":"10.1016/j.ijporl.2025.112306","url":null,"abstract":"<div><h3>Background</h3><div>Ankyloglossia describes a short lingual frenulum restricting tongue mobility. There are no universally accepted diagnostic criteria, and the rate of diagnosis and treatment are increasing. Many frenotomies are performed in the outpatient setting, making it difficult to estimate ankyloglossia incidence. This study aims to estimate the rate of diagnosis and common indications cited for treatment of ankyloglossia in a large catchment in Southwestern Ontario, Canada.</div></div><div><h3>Methods</h3><div>A survey was administered to all patients presenting to a pediatric otolaryngology clinic and five community pediatric clinics querying oral tie diagnosis, indications for treatment communicated to parents, recommended treatments, providers involved, procedure-related complications, and cost.</div></div><div><h3>Results</h3><div>Of the 266 respondents, 53.0 % (n = 141) were diagnosed with an oral tie. The most common reason to seek assessment was breast feeding difficulties (69.7 %, n = 92). The majority (78.8 %, n = 104) of patients diagnosed with a tongue tie were recommended to receive treatment, primarily frenotomy (69.7 %, n = 92). Complications included pain (24.2 %) and mild/moderate bleeding (11.0 %). Most patients paid out-of-pocket for this procedure, with only 22.6 % (n = 21) of procedures being covered by provincial insurance and 19.4 % (n = 18) by private insurance. Overall, 84.4 % (n = 76) of parents were satisfied or very satisfied with their decision to pursue treatment.</div></div><div><h3>Conclusion</h3><div>The rate of tongue tie diagnosis in survey respondents was more than double the national rate (22.6 %), possibly representing over diagnosis or overtreatment in Southwestern Ontario. Public health and education efforts may be required to ensure patients are appropriately selected for frenotomy procedures, to limit adverse outcomes and cost to patients.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"192 ","pages":"Article 112306"},"PeriodicalIF":1.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143645134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of childhood diphtheria in the popularization of the tracheostomy","authors":"Mariah Servos Li ,&nbsp;David H. Darrow","doi":"10.1016/j.ijporl.2025.112313","DOIUrl":"10.1016/j.ijporl.2025.112313","url":null,"abstract":"<div><h3>Introduction</h3><div>In the mid-nineteenth century, with the world in the grip of repeated diphtheria epidemics, tracheostomy evolved as a potentially lifesaving tool for pediatric patients. Though intubation and antitoxin eventually made the procedure all but unnecessary in diphtheria, this period spurred discussion of technique, complications, and aftercare that advanced the field of airway surgery. Growing acceptance for tracheostomy allowed twentieth-century physicians to adapt the procedure to chronic respiratory failure and pulmonary toilet and paved the way for it to become one of the most common airway surgeries performed today.</div></div><div><h3>Methods</h3><div>We performed a literature review with an emphasis on the use of primary sources with the objective of describing the development of tracheostomy during the mid-nineteenth to twentieth century.</div></div><div><h3>Results</h3><div>Tracheostomy has been used in the treatment of upper airway obstruction from foreign body since the second and third centuries B.C.E. In the nineteenth century, obstruction from pharyngeal pseudomembrane related to <em>Corynebacterium diphtheriae</em> infection became commonplace and associated with significant risk of mortality. Pierre Fidele Bretonneau and his pupil Armand Trousseau were the first to perform tracheostomy in cases of diphtheria. By 1887, over 20,000 tracheostomies had been performed in the treatment of diphtheria in Europe and America. Disagreements abounded over preferred timing, the role of anesthesia, placement technique, and post-operative care, with widespread discussion in the medical literature. Though intubation and diphtheria antitoxin ultimately replaced tracheostomy in the treatment of these patients, the use of tracheostomy in the management of upper airway obstruction from other etiologies increased after this period.</div></div><div><h3>Discussion</h3><div>The use of tracheostomy in pediatric patients with diphtheria was instrumental in standardizing the procedure, identifying its complications and their management, and promoting public acceptance of the practice as a treatment for upper airway obstruction. Today, although most of us will never see a case of diphtheria, we continue to face patients in what Scottish surgeon James Spence called “the agonies of suffocation.” That we have the tools to manage complex airway obstruction comes in part from the heroic efforts of the physicians of the nineteenth century who, despite heartbreaking losses, advanced the technique of tracheostomy in their fight against childhood diphtheria.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"192 ","pages":"Article 112313"},"PeriodicalIF":1.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep learning algorithm classification of tympanostomy tube images from a heterogenous pediatric population","authors":"Corey Bryton ,&nbsp;Sruthi Surapaneni ,&nbsp;Nikhil Rangarajan ,&nbsp;Angela Hong ,&nbsp;Alexander P. Marston ,&nbsp;Mark A. Vecchiotti ,&nbsp;Courtney Hill ,&nbsp;Andrew R. Scott","doi":"10.1016/j.ijporl.2025.112311","DOIUrl":"10.1016/j.ijporl.2025.112311","url":null,"abstract":"<div><h3>Importance</h3><div>The ability to augment routine post-operative tube check appointments with at-home digital otoscopes and deep learning AI could improve health care access as well as reduce financial and time burden on families.</div></div><div><h3>Objective</h3><div>Tympanostomy tube checks are necessary but are also burdensome to families and impact access to care for other children seeking otolaryngologic care. Telemedicine care would be ideal, but ear exams are limited. This study aimed to assess whether an artificial intelligence (AI) algorithm trained with images from an over-the-counter digital otoscope can accurately assess tube status as in place and patent, extruded, or absent.</div></div><div><h3>Design</h3><div>A prospective study of children aged 10 months to 10 years being seen for tympanostomy tube follow-up was carried out in three clinics from May–November 2023. A smartphone otoscope was used by non-MDs to capture images of the ear canal and tympanic membranes. Pediatric otolaryngologist exam findings (tube in place, extruded, absent) were used as a gold standard. A deep learning algorithm was trained and tested with these images. Statistical analysis was performed to determine the performance of the algorithm.</div></div><div><h3>Setting</h3><div>3 urban, pediatric otolaryngology clinics within an academic medical center.</div></div><div><h3>Participants</h3><div>Pediatric patients aged 10 months to 10 years with a past or current history of tympanostomy tubes were recruited. Patients were excluded from this study if they had a history of myringoplasty, tympanoplasty, or cholesteatoma.</div><div>Main Outcome MeasureCalculated accuracy, sensitivity, and specificity for the deep learning algorithm in classifying tubal status as either in place and patent, extruded in external ear canal, or absent.</div></div><div><h3>Results</h3><div>A heterogeneous group of 69 children yielded 296 images. Multiple types of tympanostomy tubes were included. The image capture success rate was 90.8 % in all subjects and 80 % in children with developmental delay/autism spectrum disorder. The classification accuracy was 97.1 %, sensitivity 97.1 %, and specificity 98.6 %.</div></div><div><h3>Conclusion</h3><div>A deep learning algorithm was trained with images from a representative pediatric population. It was highly accurate, sensitive, and specific. These results suggest that AI technology could be used to augment tympanostomy tube checks.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"192 ","pages":"Article 112311"},"PeriodicalIF":1.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143637566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventional treatment for juvenile recurrent parotitis: A 10-year experience in a tertiary centre","authors":"Saskia Boogaard ,&nbsp;Jeyasakthy Saniasiaya ,&nbsp;Craig McCaffer ,&nbsp;Edward Toll ,&nbsp;Graeme van der Meer","doi":"10.1016/j.ijporl.2025.112308","DOIUrl":"10.1016/j.ijporl.2025.112308","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the demographic characteristics, clinical characteristics, and outcomes of minimally invasive treatment for juvenile recurrent parotitis (JRP), a rare paediatric inflammatory condition affecting the parotid glands and characterised by recurrent episodes of glandular swelling and pain, at a tertiary care institution over a ten-year period.</div></div><div><h3>Methods</h3><div>This study comprised a retrospective review of patients diagnosed with JRP at a tertiary care institute between January 2013 and January 2023. The inclusion criteria were a diagnosis of JRP, and treatment with at least one surgical intervention. Demographic, clinical, and treatment data were analysed, and statistical correlations were evaluated to identify indicators of disease severity and assess the likelihood of re-intervention.</div></div><div><h3>Results</h3><div>This study enrolled 31 patients with a median age at symptom onset of 3.5 years. Māori children comprised 29 % of the cohort. Bilateral parotid gland involvement was observed in 74 % of cases, and patients experienced a median of six episodes annually. Lipiodol sialography was the most common initial intervention (61 %), associated with a 21 % re-intervention rate within one year. Sialendoscopy, an alternate treatment, required no re-interventions within the first year, but accounted for a smaller proportion of initial treatments due to limited expertise in the earlier years. Two patients (6 %) experienced major complications following lipiodol sialography.</div></div><div><h3>Conclusion</h3><div>Minimally invasive techniques, particularly sialendoscopy, demonstrated promising outcomes in managing JRP. However, treatment approaches may vary based on expertise and equipment availability. Larger randomised studies are required to establish optimal management strategies and understand the natural history of JRP.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"192 ","pages":"Article 112308"},"PeriodicalIF":1.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143629298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Supraglottoplasty on congenital tracheomalacia","authors":"Gaurav Goel ,&nbsp;Prem Sagar ,&nbsp;Rajeev Kumar ,&nbsp;Kanaram Jat ,&nbsp;Sushil Kumar Kabra ,&nbsp;Vimi Rewari ,&nbsp;Rakesh Kumar ,&nbsp;Alok Thakar","doi":"10.1016/j.ijporl.2025.112307","DOIUrl":"10.1016/j.ijporl.2025.112307","url":null,"abstract":"<div><h3>Purpose</h3><div>Evaluation of the effect of supraglottoplasty on co-existing tracheomalacia in pediatric patients with congenital laryngotracheomalacia to establish the venturi effect in vivo.</div></div><div><h3>Methods</h3><div>A prospective interventional study was conducted in a tertiary care hospital from 2020 to 2024. All consecutive pediatric patients undergoing supraglottoplasty for congenital laryngomalacia, with co-existing tracheomalacia on pre-operative bronchoscopic assessment were included and were assessed for change in severity of tracheomalacia by bronchoscopy and clinical parameters post-surgery as a comparison to the preoperative period.</div></div><div><h3>Results</h3><div>Twenty-eight patients including sixteen boys and twelve girls aged 1–30 months underwent supraglottoplasty. Statistically significant reduction in tracheal collapse was noted in all twenty-eight patients post-surgery on bronchoscopic evaluation (mean reduction by 41.45 ± 9.72 %). Clinically significant improvement was seen in terms of severity of stridor, frequency of hospitalization, apparent life-threatening events, z score for weight for age and parental perception of resolution of symptoms of their ward.</div></div><div><h3>Conclusion</h3><div>Supraglottoplasty for correction of laryngomalacia results in significant improvement in co-existing tracheomalacia. Associated medical comorbidities were not found to affect the positive outcome. Supraglottoplasty being a simple surgery with insignificant complication rate and very high success rate may be considered as the first line of surgical intervention in severely symptomatic pediatric patients with laryngotracheomalacia.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"192 ","pages":"Article 112307"},"PeriodicalIF":1.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adenotonsillectomy success for treating obstructive sleep apnea in children with Prader-Willi syndrome","authors":"Ross Rosen ,&nbsp;Jamil Hayden ,&nbsp;Abdul Saltagi ,&nbsp;Chelsea Cleveland ,&nbsp;Todd Otteson ,&nbsp;Tekin Baglam","doi":"10.1016/j.ijporl.2025.112305","DOIUrl":"10.1016/j.ijporl.2025.112305","url":null,"abstract":"<div><h3>Background</h3><div>Prader-Willi syndrome (PWS) is a rare genetic disorder that can increase risk of pediatric obstructive sleep apnea (OSA), caused by the combination of increased viscosity of secretions, craniofacial abnormalities, hypotonia, and obesity. While first-line treatment of pediatric OSA is typically adenotonsillectomy, the complex pathophysiology of OSA in PWS patients may lead to less success with this therapy.</div></div><div><h3>Methods</h3><div>The TriNetX database was queried for patients 18 years old or younger based on the diagnoses of PWS and OSA and the surgical interventions of adenotonsillectomy, tonsillectomy, and adenoidectomy. The primary endpoint was the removal of the diagnosis of OSA 6 months postoperatively. Pediatric patients without PWS were used as a control. Secondary endpoints were the risk of OSA with common medical interventions for children with PWS.</div></div><div><h3>Results</h3><div>A total of 2163 patients were found to have PWS, with 1035 (47 %) diagnosed with OSA. PWS patients undergoing surgery had a total success rate of 39.0 %, compared to 79.6 % in controls (p &lt; 0.001). Total success for these surgeries was also significantly lower compared to controls matched by demographics and obesity status (36.8 % versus 82.1 %, p &lt; 0.001). Use of growth hormone (RR 1.43, p &lt; 0.001) and testosterone (RR 1.39, p &lt; 0.001) were both associated with increased risk of OSA.</div></div><div><h3>Conclusions</h3><div>Adenotonsillectomy has significantly lower rates of success at treating pediatric OSA in patients with PWS. These patients would likely benefit from multidisciplinary care to treat their OSA and mitigate the effects of untreated disease, and further studies determining best practices for caring for these patients are necessary.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"192 ","pages":"Article 112305"},"PeriodicalIF":1.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143629297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential sleep architecture in different subtypes of positional obstructive sleep apnea in children","authors":"ChenXi Luo,&nbsp;Qi Li,&nbsp;WenBo Chen","doi":"10.1016/j.ijporl.2025.112312","DOIUrl":"10.1016/j.ijporl.2025.112312","url":null,"abstract":"<div><h3>Study objectives</h3><div>This study aimed to compare the clinical characteristics of two types of positional obstructive sleep apnea (POSA) in children: supine dominant OSA (spOSA) and supine isolated OSA (siOSA). The goal was to investigate the differences in sleep structures between the two groups.</div></div><div><h3>Methods</h3><div>A total of 384 children with OSA were included. Children with POSA were categorized into two subgroups: siOSA for those with a non-supine AHI &lt;1, and spOSA for those with a non-supine AHI ≥1. Clinical characteristics and polysomnographic features were compared between the two groups.</div></div><div><h3>Results</h3><div>Among the 384 patients with OSA, 128 (33.3 %) were classified as POSA. Weight, BMI, and BMI Z-scores were higher in the POSA group compared to the non-POSA group (NPOSA). Polysomnography (PSG) data indicated that total sleep time (TST) and N2 % were higher in the POSA group than in the NPOSA group. Minimum SaO₂ was lower in the POSA group, and oxygen desaturation index(ODI)values were higher compared to the NPOSA group. The rate of overweight and obesity was higher in the POSA group. Among the 128 POSA cases, 47 (36.7 %) were classified as spOSA and 81 (63.3 %) as siOSA. The siOSA patients were younger than those in the spOSA group. SiOSA patients had a higher N2 %, lower R %, and lower AHI, AHI_NREM, AHI_REM, OAHI, HI, and ODI compared to spOSA patients. The spOSA group had a higher rate of severe OSA compared to the siOSA group.</div></div><div><h3>Conclusion</h3><div>This study found significant differences between children with spOSA and siOSA. The spOSA group had higher values in AHI-related parameters. The spOSA group also showed a higher rate of moderate-to-severe OSA. In contrast, the siOSA group had younger age. Additionally, the siOSA group displayed abnormal sleep architecture: higher N2 % and lower R %. These differences suggest distinct pathological mechanisms may exist between the two subtypes. Therefore, targeted clinical strategies should be developed for each subtype.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"192 ","pages":"Article 112312"},"PeriodicalIF":1.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143642286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The intricate interrelationship of cochlear aperture and internal auditory canal diameter in pediatric normal petrous structures","authors":"Diksha Kumari ,&nbsp;Richi Sinha ,&nbsp;Umakant Prasad ,&nbsp;Rakesh Kumar Singh","doi":"10.1016/j.ijporl.2025.112296","DOIUrl":"10.1016/j.ijporl.2025.112296","url":null,"abstract":"<div><h3>Purpose</h3><div>The cochlear aperture and internal auditory canal dimensions play a pivotal role in cochlear nerve health, yet their normative data exhibit significant variability. This study seeks to establish definitive normative ranges for these dimensions and investigate their interrelationship in the context of normally developed pediatric temporal bones.</div></div><div><h3>Methods</h3><div>This prospective study included seventy-eight children under fifteen years, diagnosed with bilateral severe-to-profound sensorineural hearing loss and free from temporal bone deformities. Utilizing high-resolution computed tomography scans, we measured the diameters of the cochlear aperture at the mid-modiolar level and the internal auditory canal at the porus, midsection, and fundus. The associations between these dimensions were analyzed using Spearman's rank correlation and linear regression.</div></div><div><h3>Results</h3><div>The mean cochlear aperture diameter was 2.16 mm, while the internal auditory canal diameters at the porus, midsection, and fundus were 6.60 mm, 4.27 mm, and 3.88 mm, respectively. Significant positive correlations were observed between the cochlear aperture and internal auditory canal diameters at the midsection (rs = 0.246, p = 0.029) and fundus (rs = 0.338, p = 0.002), as well as the average internal auditory canal diameter (rs = 0.233, p = 0.039). Regression analysis indicated that the internal auditory canal diameter at the fundus explained 17.5 % of the variance in cochlear aperture diameter (β = 0.179, p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>This study established normative ranges for cochlear aperture and internal auditory canal dimensions in children, addressing past variability. These findings support cochlear implant planning, with a regression model offering a noninvasive tool to estimate cochlear aperture size. We also identified a unique, significant correlation between the two, highlighting a shared developmental pathway.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"192 ","pages":"Article 112296"},"PeriodicalIF":1.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143576768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}